慢性心力衰竭中医证型与B型钠尿肽关系对照研究

[目的]分析慢性心力衰竭(CHF)患者不同中医证型与BNP水平的相关性,探讨BNP作为CHF中医辨证分型客观指标的可行性。[方法]选取本院诊断为慢性心力衰竭的患者117例作为研究对象,进行中医辨证分型,另外选取健康体检者23例作为对照组,所有患者抽取血液采用免疫荧光法测定BNP,并同时进行心脏彩超检查测定LVEF,结果进行统计学分析。[结果]CHF病人BNP水平明显高于对照组,BNP的水平随心力衰竭加重而上升,与NYHA心功能分级呈正相关(r=0.813,P<0.001)。CHF病人LVEF明显低于对照组,LVEF随心力衰竭加重而降低,与NYHA心功能分级呈负相关(r=-0.627,P<0.001)。BNP水平与中医证型间存在正相关性(r=0.773,P<0.001),BNP水平按心肺气虚、心气阴虚兼血瘀→气虚血瘀→心脾阳虚兼血瘀水停→心脾肾阳虚水泛兼血瘀逐级递增。LVEF与中医证型间存在负相关性(r=-0.679,P<0.001),LVEF按照心肺气虚→心气阴虚兼血瘀→气虚血瘀、心脾阳虚兼血瘀水停→心脾肾阳虚水泛兼血瘀逐级递减。[结论]慢性心力衰竭中医证型与BNP具有相关性,BNP可作为CHF中医辨证分型的一个客观化指标。

Control Study of Correlation of BNP in Chronic Heart Failure with Traditional Chinese Medicine Syndrome Types

[Objectives]To investigate the possibility of BNP as a biological marker for traditional Chinese medicine（TCM）Syndrome types and to analyze relation between BNP level and TCM syndrome types in patients with chronic heart failure（CHF）.[Methods]Select 117 patients with CHF as research object and then select 23 healthy persons as control object,The 117 patients were analyzed with TCM syndrome differentiation,and BNP level was analyzed quantitatively with Immunofluorescence assay.All the patients were examined with cardiac color dopplar ultrasound and the result determination LVEF were analysised.[Results]The BNP concentrations in patients with CHF were significantly higher than that in healthy controls.BNP concentrations increased with CHF severity and were positively correlated with the NYHA classification system（r=0.813,P0.001）.The LVEF concentrations in patients with CHF were significantly lower than that in healthy controls.LVEF concentrations reduced with CHF severity and were negatively correlated with the NYHA classification system（r=-0.627,P0.001）.The BNP concentrations were positively correlated with TCM Syndrome typing（r=0.773,P0.001）.The LVEF concentrations were negatively correlated with TCM Syndrome typing（r=-0.679,P0.001）.[Conclusion] The was a relationship between BNP level and TCM syndrome types in patients with CHF,BNP level might be a biological marker for TCM syndrome type determination in patients with CHF.